The American Hospital Association, in a letter dated May 21 and sent to the Senate Finance Committee, outlined a number of concerns it has over how a public health plan might be structured.
The committee has outlined three possible shapes a public plan may take. Two of the three would allow the federal government to set payment rates. A chief concern, the AHA letter states, centers on a history of government underpayments in programs such as Medicare and Medicaid. According to a 2007 AHA survey, 58% of U.S. hospitals, or 2,840, said they were not paid their cost for providing care to Medicare patients. With Medicaid, hospitals lost some $10.4 billion in 2007 due to payment shortfalls.